Using the prototype of a wide angle (84 degrees) phased array sector scanner echocardiographic real-time two-dimensional imaging system, we have demonstrated the feasibility of obtaining biplane images of the left ventricle which closely approximate biplane angiograms in their ability to be used to measure left ventricular systolic and diastolic blood volume. The method utilized to establish this relationship involves manual digitization of the images with computer generated volume analysis. The method required hand drawing of end-diastolic and end-systolic images from video tape playback. This last step was time consuming and tedious. Our experience and findings led to the development of a light pen computation system prototype designed for use with our two-dimensional scanner and place in our laboratory for evaluation. This device makes application of our techniques rapid and practicle for clinical and investigational use and makes quantitation of wall motion a possibility to be investigated. Thus, the proposed project will investigate the ability of the biplane echographic technique to be performed using a variety of geometric assumptions (single plane area length, biplane area length and Simpson's rule). To this end, patients undergoing biplane left ventricular angiography will also have biplane echocardiography. Apex echocardiography (use of the apex impulse location as a window for imaging), developed in our laboratory and used in our initial study will be used singly or in combination with other approaches in order to determine the view or views which most closely approximate the angiogram. The ventricle will also be divided into segments for the study of regional wall motion and these results will be compared to the angiographic standard. The establishment of these noninvasive techniques will be followed by their use to study the progression of disease and the effects of various interventions such as afterload reduction, surgery or angiographic dye injection.